Provider Demographics
NPI:1881252997
Name:SOLACE THERAPY LLC
Entity type:Organization
Organization Name:SOLACE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/ PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBT, LBT,LCDC
Authorized Official - Phone:409-984-3016
Mailing Address - Street 1:726 DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-2306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 FM 365
Practice Address - Street 2:SUITE 209A
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6250
Practice Address - Country:US
Practice Address - Phone:409-984-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder